The effect of prolonged ED stay on outcome in patients with necrotizing fasciitis
Abstract Objective Overcrowding in hospitals, especially in EDs, is a serious problem in the United States, Europe, and Taiwan. However, the association between prolonged ED boarding stay and mortality in patients with necrotizing fasciitis remains underinvestigated. Methods This was a retrospective...
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| Veröffentlicht in: | The American journal of emergency medicine 2009-05, Vol.27 (4), p.385-390 |
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| creator | Hong, Yu-Cheng, MD Chou, Meng-Hua, MD Liu, Estella H., MS Hsiao, Cheng-Ting, MD Kuan, Jen-Tse, MD Lin, Ju-Chan, MD Chen, I-Chuan, MD |
| description | Abstract Objective Overcrowding in hospitals, especially in EDs, is a serious problem in the United States, Europe, and Taiwan. However, the association between prolonged ED boarding stay and mortality in patients with necrotizing fasciitis remains underinvestigated. Methods This was a retrospective study. A total of 195 patients were enrolled and analyzed. The sample was divided into 2 groups: nonmortality and mortality. A stepwise logistic regression model was developed to investigate 3 factors of clinical relevance predicting patient mortality. Result The results of the stepwise logistic regression analysis revealed that hypotension (odds ratio [OR], 32.9; 95% confidence interval [CI], 6.9-156.0) and prolonged ED boarding stay (OR, 3.4; 95% CI 1.3-8.6) were both associated with higher mortality. Early operation (OR: 0.16; 95% CI: 0.06 – 0.45) was associated with lower mortality. Conclusion Prolonged ED boarding stay was associated with increased mortality in patients with necrotizing fasciitis. Early operation (within 24 hours of ED arrival) was associated with decreased mortality. |
| doi_str_mv | 10.1016/j.ajem.2008.03.010 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67425061</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0735675708002167</els_id><sourcerecordid>2727337291</sourcerecordid><originalsourceid>FETCH-LOGICAL-c467t-36cbca9a9144a80d43742e0d2f92115271bfe5fac6458fc9b157a34d7dcf2d033</originalsourceid><addsrcrecordid>eNp9kk1v1DAQhiMEokvhD3BAlhDcEsZ2bCcSQkJt-ZAqIUQ5W15n3Dok9jZOqJZfj6NdUakHTr48M37nmSmKlxQqClS-6yvT41gxgKYCXgGFR8WGCs7Khir6uNiA4qKUSqiT4llKPQCltaifFie0FUJIkJvi-9UNEnQO7UyiI7spDjFcY0cuzkmazZ7EQOIy2zgi8YHszOwxzInc-fmGBLRTnP0fH66JM8l6P_v0vHjizJDwxfE9LX5-urg6-1Jefvv89ezjZWlrqeaSS7u1pjUtrWvTQFdzVTOEjrmWUSqYoluHwhkra9E4226pUIbXneqsYx1wflq8PfTNmW8XTLMefbI4DCZgXJKWuZ8ASTP4-gHYx2UKOZumwKFpJQOWKXag8kgpTej0bvKjmfYZ0qtu3etVt151a-A6685Fr46tl-2I3X3J0W8G3hyBrMcMbjLB-vSPYzQnZE2dufcHDrOx3x4nnW1isNj5Ka9Gd9H_P8eHB-V28MHnH3_hHtP9vDoxDfrHehjrXUADwKhU_C98urGC</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1030896202</pqid></control><display><type>article</type><title>The effect of prolonged ED stay on outcome in patients with necrotizing fasciitis</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>ProQuest Central UK/Ireland</source><creator>Hong, Yu-Cheng, MD ; Chou, Meng-Hua, MD ; Liu, Estella H., MS ; Hsiao, Cheng-Ting, MD ; Kuan, Jen-Tse, MD ; Lin, Ju-Chan, MD ; Chen, I-Chuan, MD</creator><creatorcontrib>Hong, Yu-Cheng, MD ; Chou, Meng-Hua, MD ; Liu, Estella H., MS ; Hsiao, Cheng-Ting, MD ; Kuan, Jen-Tse, MD ; Lin, Ju-Chan, MD ; Chen, I-Chuan, MD</creatorcontrib><description>Abstract Objective Overcrowding in hospitals, especially in EDs, is a serious problem in the United States, Europe, and Taiwan. However, the association between prolonged ED boarding stay and mortality in patients with necrotizing fasciitis remains underinvestigated. Methods This was a retrospective study. A total of 195 patients were enrolled and analyzed. The sample was divided into 2 groups: nonmortality and mortality. A stepwise logistic regression model was developed to investigate 3 factors of clinical relevance predicting patient mortality. Result The results of the stepwise logistic regression analysis revealed that hypotension (odds ratio [OR], 32.9; 95% confidence interval [CI], 6.9-156.0) and prolonged ED boarding stay (OR, 3.4; 95% CI 1.3-8.6) were both associated with higher mortality. Early operation (OR: 0.16; 95% CI: 0.06 – 0.45) was associated with lower mortality. Conclusion Prolonged ED boarding stay was associated with increased mortality in patients with necrotizing fasciitis. Early operation (within 24 hours of ED arrival) was associated with decreased mortality.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2008.03.010</identifier><identifier>PMID: 19555606</identifier><identifier>CODEN: AJEMEN</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Emergency ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care ; Emergency medical care ; Emergency Service, Hospital - utilization ; Fasciitis, Necrotizing - mortality ; Fasciitis, Necrotizing - surgery ; Female ; Heart attacks ; Hospital Mortality ; Hospitalization ; Hospitals ; Humans ; Intensive care medicine ; Length of Stay ; Logistic Models ; Male ; Medical sciences ; Middle Aged ; Mortality ; Multivariate Analysis ; Overcrowding ; Primary care ; Regression analysis ; Retrospective Studies ; Risk Factors ; Studies ; Taiwan - epidemiology ; Waiting Lists</subject><ispartof>The American journal of emergency medicine, 2009-05, Vol.27 (4), p.385-390</ispartof><rights>Elsevier Inc.</rights><rights>2009 Elsevier Inc.</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c467t-36cbca9a9144a80d43742e0d2f92115271bfe5fac6458fc9b157a34d7dcf2d033</citedby><cites>FETCH-LOGICAL-c467t-36cbca9a9144a80d43742e0d2f92115271bfe5fac6458fc9b157a34d7dcf2d033</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1030896202?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974,64362,64364,64366,72216</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21506284$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19555606$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hong, Yu-Cheng, MD</creatorcontrib><creatorcontrib>Chou, Meng-Hua, MD</creatorcontrib><creatorcontrib>Liu, Estella H., MS</creatorcontrib><creatorcontrib>Hsiao, Cheng-Ting, MD</creatorcontrib><creatorcontrib>Kuan, Jen-Tse, MD</creatorcontrib><creatorcontrib>Lin, Ju-Chan, MD</creatorcontrib><creatorcontrib>Chen, I-Chuan, MD</creatorcontrib><title>The effect of prolonged ED stay on outcome in patients with necrotizing fasciitis</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>Abstract Objective Overcrowding in hospitals, especially in EDs, is a serious problem in the United States, Europe, and Taiwan. However, the association between prolonged ED boarding stay and mortality in patients with necrotizing fasciitis remains underinvestigated. Methods This was a retrospective study. A total of 195 patients were enrolled and analyzed. The sample was divided into 2 groups: nonmortality and mortality. A stepwise logistic regression model was developed to investigate 3 factors of clinical relevance predicting patient mortality. Result The results of the stepwise logistic regression analysis revealed that hypotension (odds ratio [OR], 32.9; 95% confidence interval [CI], 6.9-156.0) and prolonged ED boarding stay (OR, 3.4; 95% CI 1.3-8.6) were both associated with higher mortality. Early operation (OR: 0.16; 95% CI: 0.06 – 0.45) was associated with lower mortality. Conclusion Prolonged ED boarding stay was associated with increased mortality in patients with necrotizing fasciitis. Early operation (within 24 hours of ED arrival) was associated with decreased mortality.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Emergency</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Emergency medical care</subject><subject>Emergency Service, Hospital - utilization</subject><subject>Fasciitis, Necrotizing - mortality</subject><subject>Fasciitis, Necrotizing - surgery</subject><subject>Female</subject><subject>Heart attacks</subject><subject>Hospital Mortality</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Length of Stay</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Overcrowding</subject><subject>Primary care</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Studies</subject><subject>Taiwan - epidemiology</subject><subject>Waiting Lists</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kk1v1DAQhiMEokvhD3BAlhDcEsZ2bCcSQkJt-ZAqIUQ5W15n3Dok9jZOqJZfj6NdUakHTr48M37nmSmKlxQqClS-6yvT41gxgKYCXgGFR8WGCs7Khir6uNiA4qKUSqiT4llKPQCltaifFie0FUJIkJvi-9UNEnQO7UyiI7spDjFcY0cuzkmazZ7EQOIy2zgi8YHszOwxzInc-fmGBLRTnP0fH66JM8l6P_v0vHjizJDwxfE9LX5-urg6-1Jefvv89ezjZWlrqeaSS7u1pjUtrWvTQFdzVTOEjrmWUSqYoluHwhkra9E4226pUIbXneqsYx1wflq8PfTNmW8XTLMefbI4DCZgXJKWuZ8ASTP4-gHYx2UKOZumwKFpJQOWKXag8kgpTej0bvKjmfYZ0qtu3etVt151a-A6685Fr46tl-2I3X3J0W8G3hyBrMcMbjLB-vSPYzQnZE2dufcHDrOx3x4nnW1isNj5Ka9Gd9H_P8eHB-V28MHnH3_hHtP9vDoxDfrHehjrXUADwKhU_C98urGC</recordid><startdate>20090501</startdate><enddate>20090501</enddate><creator>Hong, Yu-Cheng, MD</creator><creator>Chou, Meng-Hua, MD</creator><creator>Liu, Estella H., MS</creator><creator>Hsiao, Cheng-Ting, MD</creator><creator>Kuan, Jen-Tse, MD</creator><creator>Lin, Ju-Chan, MD</creator><creator>Chen, I-Chuan, MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20090501</creationdate><title>The effect of prolonged ED stay on outcome in patients with necrotizing fasciitis</title><author>Hong, Yu-Cheng, MD ; Chou, Meng-Hua, MD ; Liu, Estella H., MS ; Hsiao, Cheng-Ting, MD ; Kuan, Jen-Tse, MD ; Lin, Ju-Chan, MD ; Chen, I-Chuan, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c467t-36cbca9a9144a80d43742e0d2f92115271bfe5fac6458fc9b157a34d7dcf2d033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Emergency</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</topic><topic>Emergency medical care</topic><topic>Emergency Service, Hospital - utilization</topic><topic>Fasciitis, Necrotizing - mortality</topic><topic>Fasciitis, Necrotizing - surgery</topic><topic>Female</topic><topic>Heart attacks</topic><topic>Hospital Mortality</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Length of Stay</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Overcrowding</topic><topic>Primary care</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Studies</topic><topic>Taiwan - epidemiology</topic><topic>Waiting Lists</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hong, Yu-Cheng, MD</creatorcontrib><creatorcontrib>Chou, Meng-Hua, MD</creatorcontrib><creatorcontrib>Liu, Estella H., MS</creatorcontrib><creatorcontrib>Hsiao, Cheng-Ting, MD</creatorcontrib><creatorcontrib>Kuan, Jen-Tse, MD</creatorcontrib><creatorcontrib>Lin, Ju-Chan, MD</creatorcontrib><creatorcontrib>Chen, I-Chuan, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hong, Yu-Cheng, MD</au><au>Chou, Meng-Hua, MD</au><au>Liu, Estella H., MS</au><au>Hsiao, Cheng-Ting, MD</au><au>Kuan, Jen-Tse, MD</au><au>Lin, Ju-Chan, MD</au><au>Chen, I-Chuan, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effect of prolonged ED stay on outcome in patients with necrotizing fasciitis</atitle><jtitle>The American journal of emergency medicine</jtitle><addtitle>Am J Emerg Med</addtitle><date>2009-05-01</date><risdate>2009</risdate><volume>27</volume><issue>4</issue><spage>385</spage><epage>390</epage><pages>385-390</pages><issn>0735-6757</issn><eissn>1532-8171</eissn><coden>AJEMEN</coden><abstract>Abstract Objective Overcrowding in hospitals, especially in EDs, is a serious problem in the United States, Europe, and Taiwan. However, the association between prolonged ED boarding stay and mortality in patients with necrotizing fasciitis remains underinvestigated. Methods This was a retrospective study. A total of 195 patients were enrolled and analyzed. The sample was divided into 2 groups: nonmortality and mortality. A stepwise logistic regression model was developed to investigate 3 factors of clinical relevance predicting patient mortality. Result The results of the stepwise logistic regression analysis revealed that hypotension (odds ratio [OR], 32.9; 95% confidence interval [CI], 6.9-156.0) and prolonged ED boarding stay (OR, 3.4; 95% CI 1.3-8.6) were both associated with higher mortality. Early operation (OR: 0.16; 95% CI: 0.06 – 0.45) was associated with lower mortality. Conclusion Prolonged ED boarding stay was associated with increased mortality in patients with necrotizing fasciitis. Early operation (within 24 hours of ED arrival) was associated with decreased mortality.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>19555606</pmid><doi>10.1016/j.ajem.2008.03.010</doi><tpages>6</tpages></addata></record> |
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| subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Emergency Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Emergency medical care Emergency Service, Hospital - utilization Fasciitis, Necrotizing - mortality Fasciitis, Necrotizing - surgery Female Heart attacks Hospital Mortality Hospitalization Hospitals Humans Intensive care medicine Length of Stay Logistic Models Male Medical sciences Middle Aged Mortality Multivariate Analysis Overcrowding Primary care Regression analysis Retrospective Studies Risk Factors Studies Taiwan - epidemiology Waiting Lists |
| title | The effect of prolonged ED stay on outcome in patients with necrotizing fasciitis |
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